Drs. Brahms, Cohn & Leb Inc. have a rich heritage in orthopaedic care for the people of Northeast Ohio. The practice was started over 50 years ago when Dr. Malcolm Brahms joined Dr. Alvin Tramer's orthopaedic practice.
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Foraminotomy (Lumbar & Cervical)

Cervical Foraminotomy

Cervical foraminotomy is an operative procedure to relieve the symptoms of pinched or compressed spinal nerve by enlarging the neural foramen, an opening for the nerve roots to exit from the spine and travel throughout the body. The neural foramen forms a protective passageway for nerves that transmit signals among the spinal cord and the rest of the body parts.

Cervical foraminotomy can also be done through a minimal invasive approach. It does not require cutting and stripping the muscles from the spine region, unlike the conventional open spine surgery which requires spine muscles to be cut or stripped.

Who requires this procedure?

Conditions such as herniated discs, bone spurs, and thickened ligaments or joints can narrow the neural foramen and pinch the spinal nerves. A pinched or compressed nerve in the neck region can cause neck pain, stiffness and/or pain, tingling sensation, numbness or weakness that radiates down to the arm and hand. Patients with these symptoms who fail to show improvement with non-surgical therapy require cervical foraminotomy procedure.

How is the procedure performed?

Procedure

The procedure is done with the patient resting on his/her stomach.

Decompression

Your surgeon makes a small incision on the symptomatic side of your neck and approaches the spine by bringing the neck muscles apart using a retractor. Then, the bone or disc material and/or the thickened ligaments are removed, relieving the pressure on spinal nerve structures creating decompression. Afterwards, the neck muscles are brought back by removing the retractor.

Closure

After the procedure, your surgeon closes the incision using sutures which might develop into a small scar.

After the procedure

Since the procedure is minimally invasive, most of the patients can be discharged on the day of surgery itself, but some patients may need a longer hospital stay. After surgery, the pain symptoms may improve immediately or gradually over the course of time. Compliance with your surgeon’s post-operative instructions may give better results. You will be able to resume your daily activities within a few weeks.

Your physician recommends surgery based on your condition and symptoms. Before scheduling the surgery, discuss the benefits, Risks & Complications of the surgical procedure with your surgeon.

Lumbar Foraminotomy

The spine is surrounded and protected by vertebral bones stacked one on top of the other. Between adjacent vertebrae are spaces called neural foramen through which spinal nerves pass to communicate with the rest of the body. Conditions such as a herniated intervertebral disc or bony overgrowth may cause compression of the spinal nerves as they pass through the neural foramen. In the lower back or lumbar region, this can result in lower back pain as well as pain, weakness and numbness in the legs. A lumbar foraminotomy is a surgical procedure to decompress the spinal nerves by removing bone and other tissues that obstruct the neural foramen.

For the procedure you will lie face down and the site of surgery is identified by X-ray imaging. An incision is made in the skin and tissues separated and retracted to expose the affected area. Special instruments are used to remove bone spurs, thickened ligaments and all or part of the disc causing nerve compression. A microscope is used to verify whether decompression of the spinal nerves is complete. The instruments are then removed and the incision closed.

You are usually discharged on the same day of surgery and may experience relief immediately after surgery. In case of pain, your doctor will prescribe medication. You will receive advice on wound care and activity limitation.

As with any invasive procedure, lumbar foraminotomy may be associated with certain complications such as infection, bleeding, nerve damage and leakage of spinal fluid.